The Advantage of a Right-Side Retroperitoneal Approach for Anterior Lumbar Spine Access

Lumbar total disc replacement has become increasingly common in the treatment of chronic low back pain. Despite this recent rise in popularity, revision surgery is sometimes necessary due to long-term wear or errors in implant sizing and positioning. Although the left retroperitoneal plane is often the preferred course when exposing the lumbar spine anterolaterally, the benefits associated with a right-side approach warrant exploration. When reoperation follows the same trajectory as the primary surgery, prior surgical scarring can increase the risk of iatrogenic injury. Despite this, a repeat left-side approach is commonly performed. This study identified a right-side retroperitoneal approach as a clinically relevant and feasible strategy in primary lumbar total disc replacement surgery to preserve the left-side retroperitoneal plane should reoperation become necessary in the future.